Correlation between 24-hour profile of blood pressure and ventricular arrhythmias and their prognostic significance in patients with arterial hypertension

Abstract

Background/Aim. Left ventricular hypertrophy (LVH), apart from arterial hypertension, is a risk factor for electrophysiologic heart condition disorder and sudden cardiac death. The aim of this study was to examine a relationship between complex ventricular arrhythmias and parameters of 24-hour ambulatory blood pressure monitoring in the patients with arterial hypertension and left ventricular hypertrophy (LVH), as well as their prognostic significance during a five-year follow-up. Methods. Ninety patients with arterial hypertension and LVH were included in this study (mean age 55.2?8.3 years). There were 35 healthy people in the control group (mean age 54.5?7.1 years). Left ventricular mass index was 171.9?32.4 g/m2 in the LVH group and 102.4?13.3 g/m2 in the control group. Clinical examination, echocardiogram, 24-hour ambulatory blood pressure monitoring and 24-hour holter monitoring were done in all of the examined persons. Ventricular arrhythmias were classified by the Lown classification. Results. In the LVH group there were 54 (60.0%) of the patients with ? III Lown class. The best predictor of a Lown class were left ventricular mass index by using multivariate stepwise regression analyses (? = 0.212; p < 0.05) and small decrease of diastolic blood pressure during the night (? = -0.293; p < 0.01). The main predictor of bad prognosis was left ventricular mass index during a five year follow-up (? = 0.302; p < 0.01, for stepwise regression model: F = 8.828; p < 0.01, adjusted R2 = 0.091). Conclusion. Left ventricular arrhythmias are frequent in patients with lower decrease of blood pressure during the night. There was no correlation between the degree of ventricular arrhythmias and parameters from 24-hour blood pressure monitoring and a five-year prognosis in the patients with arterial hypertension and LVH. A bad five-year follow-up outcome of hypertensive disease depends on left ventricular mass index.